Early Check Release
Employee Name:
ER #1:
OFFICE USE ONLY
ER #2:
Travel:
Date Phone Number
Phone NumberDate
Employee Signature
Executive Director Signature
I understand that this form is to be submitted to the Finance Department/Payroll by noon on non-payroll
week Wednesday. A time sheet/card and leave slip must be attached to this form documenting work day(s)
off. I must be absent on the entire week preceding payroll Friday to be eligible to receive an Early Release.
Also, all regular hours must be worked, before the check can be released. For absences due to travel/training
on Tribal business, this form will have a copy of the fully approved training request. Early checks will be
issued according the Finance Department’s standard operating procedures as stated under the most recent
revision of the “Payroll Policies/Procedures.” I can find the payroll policy online at the Tulalip Tribes website.
This form must be time and date stamped before it is turned into payroll. However, I understand that this
request is not considered valid as received unless it is completed, fully authorized and has all required leave
slips/backup attached.
I further understand that if payroll inadvertently generates another check for me on the regular payroll run for
the same days covered on this early check release and I do not report it to payroll, it will be considered theft
and disciplinary action, up to termination, will ensue.
The days requested on this leave form must to be taken off. (By requesting an early release check, the day
(days) requested on my form, for which I am being compensated for in my early release check is
(are) required to be taken off and I will not be allowed to receive credit for that day (those days.) If I show up
at my work site on that day (those days) off I will be sent home.
Early Releases will only be processed on non-payroll Fridays
mm/dd/yy
mm/dd/yy
The signature below certies authorization:
Department:Job Title:
TDS-21014 (12/2016)
I will not be working on (leave slip/travel request attached) therefore,
I am requesting my payroll check be release on .
